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In India, eliminating tuberculosis isn't just a health issue — it's an economic one

Jorge Coarasa's picture



On February 1st, India’s finance minister presented the Union Budget for 2017-2018, and announced the government’s plan to eliminate tuberculosis (TB) by 2025. This is a welcome move. While ridding people of the burden of any disease is a worthy goal by itself, TB elimination provides perhaps one of the strongest cases for public intervention from an economic point of view.

All communicable diseases present what economists call externalities: infectious people can infect other people who in turn infect others and so on. In fact, economist Phillip Musgrove used TB in particular to illustrate this: “no victim of tuberculosis is likely to ignore the disease, so there is no problem of people undervaluing the private benefits of treatment. Rather, the cost of treatment--and the fact that they may feel better even though the disease has not been cured-- may lead people to abandon treatment prematurely, with bad consequences not only for themselves but for others. The rest of society therefore has an interest in treating those with tuberculosis, and assuming at least part of the cost.” Reducing TB incidence could generate benefits of $33 per dollar spent, prompting The Economist to put TB among their list of ‘no-brainers’. According to the Stop TB Partnership, ending TB globally could yield US$ 1.2 trillion overall economic return on investment.

Bank supports launch of certificate course on contractual dispute resolution in India

Shanker Lal's picture
Powerlines in Mumbai. Photo: Simone D. McCourtie / World Bank


India is the fastest-growing major economy in the world with significant Government investments in infrastructure. According to estimates by WTO and OECD, as quoted in a report from the United Nations Office on Drugs and Crime, India: Probity in Public Procurement, the estimated public procurement in India is between 20 and 30 percent of GDP. 

This translates to Indian government agencies issuing contracts worth an estimated US$ 419 billion to US$ 628 billion each year for various aspects of infrastructure projects. Ideally, in contractual agreements no disputes would arise and both sides would benefit from the outcome. However, unexpected events occur and many contracts end in dispute. Contractual legal disputes devoid project benefits to the public as time and resources are spent in expensive arbitration and litigation. As a result, India’s development goals are impacted.

The “5Ds”: Changing attitudes to open defecation in India

Vandana Mehra's picture
In the village of Bharsauta in Uttar Pradesh, India, construction worker Vishwanath lives with his wife, four children and their elderly parents. Three years ago, the government paid to build a toilet in their house. But the job was not done well: the pit was too shallow, it overflows frequently, and the smell makes it suffocating to use.

Women, cities, and opportunity: Making the case for secure land rights

Klaus Deininger's picture

Also available in: Français 

Land and property lie at the center of many of today’s pressing development challenges. Consider that at most 10% of land in rural Africa is reliably registered. At this week‘s annual Land and Poverty Conference here at the World Bank, we will hear how this vast gap in documentation of land gap blunts access to opportunities and key services for millions of the world’s poorest people, contributes to gender inequality, and undermines environmental sustainability.

Climate change is forcing us to reinvent rural transport for the better

Ashok Kumar's picture
Photo: Ravisankar Pandian/Flickr
India is in the midst of implementing PMGSY, a $35-billion national level Rural Road Program designed to provide basic road access to rural communities. The World Bank is supporting PMGSY through a series of lending operations ($1.8 billion in Bank funding) and significant knowledge support. A key element of the Bank’s support has been to integrate a “climate and green growth lens” into these efforts in cost-effective ways.

How is “green growth” benefiting India? One important dimension of that effort has been  the use of environmentally optimized road designs, which has resulted in quality infrastructure using local and marginal materials, providing both economic and environmental benefits. Where available, sand deposits accumulated from frequent floods, industrial by-products, and certain types of plastic, mining, and construction waste have been used to good effect. Designs that use such materials have been about 25% cheaper to build, on average, than those requiring commonly used rock aggregates. The environmental benefits of using the above materials, in terms of addressing the big disposal problem of such materials and reducing the consumption of scarce natural stone aggregates, are as significant as the cost savings.

A second “green growth” dimension has been focusing investments on the “core” network, i.e. the network India needs to develop in order to provide access to all villages. Relative to a total rural road network of about 3.3 million kilometers, the core network that falls under PMGSY stretches over only 1.1 million kilometers. Prioritizing construction and maintenance on those critical road links will bring down costs as well as the associated carbon footprint.

Simulating job growth through macro models

Camilo Mondragon-Velez's picture
Simulating job growth through macro models
Macro models aim to better track the ripple of jobs generated throughout the economy from private sector investments and interventions. Photo: Yang Aijun / World Bank
 

We are developing Macro Simulation Models to estimate how investments and interventions may generate jobs. Following the  Jobs Study conducted by the International Finance Corporation (IFC), the World Bank Group’s private sector arm, the Let’s Work Partnership was established to develop, refine, and apply tools to estimate direct, indirect, and induced job effects. Macro models are one of these tools.

How to effectively manage metropolitan areas?

Ede Ijjasz-Vasquez's picture
​Today, a quarter of the world’s population lives in urban “agglomerations”—supersized metropolitan areas that cut across jurisdictional boundaries and bring together one or more cities along with their surrounding areas.

These metropolitan areas face a common challenge: effectively coordinating planning, infrastructure development, and service delivery across multiple jurisdictions. This is particularly difficult in developing countries, which often lack the necessary legal, institutional, and governance apparatus to undertake such coordination. The New Urban Agenda issued by the Habitat III conference in 2016 identified metropolitan planning and management as one of the most critical needs to ensure sustainable urbanization.

Fortunately, there is growing evidence and good practice from various countries on how to effectively manage and govern metropolitan areas. To help spread existing good practice and co-create new solutions, the World Bank has been supporting a community of practice (CoP) on metropolitan governance, or MetroLab, which brings together officials from metropolitan areas in both developing and developed countries for peer-peer knowledge and experience sharing.  Since its launch in 2013, MetroLab has held eight meetings in various cities, including Bangkok, Mumbai, New York, Paris, Rio de Janeiro, and Seoul.

​The most recent meeting took place in Tokyo from January 30 through February 2. Organized by the World Bank’s Tokyo Development Learning Center, the Tokyo MetroLab brought together mayors, city planners, and finance officials from nine developing cities. They were joined by experts from the World Bank, New York’s Regional Plan Association, the Seoul Metropolitan Government, and Advancity—Paris’ Smart Metropolis Hub.

In this video, Lydia Sackey-Addy, one of the participating officials from Accra, Ghana, as well as the World Bank’s Senior Director Ede Ijjasz-Vasquez (@Ede_WBG) and Lead Urban Economist Maria Angelica Sotomayor (@masotomayor) tell us how they are working together to make the Accra metropolitan area more resilient and sustainable for its residents.


 

Building institutional capacity for rural sanitation: India’s Uttar Pradesh State

Mariappa Kullappa's picture
Uttar Pradesh (UP), India’s most populous state with about 200 million people, has historically not performed well on sanitation. According to census figures from 2001 and 2011, the proportion of rural UP dwellers with a toilet increased slightly during the first decade of this century. However, the population grew as well, meaning that, overall, 13 million more people were defecating in the open in 2011. 

Women can play a greater role in realizing South Asia’s potential

Annette Dixon's picture
Mumbai Train
The suburban train system in Mumbai is used by millions of women and men everyday, who rely on safe transport to access education and job opportunities. 

Last week, I took a journey on Mumbai’s suburban train system, which carries a staggering 8 million women and men, equivalent to the entire population of Switzerland, every day to where they live, work, and spend time with family and friends. Although stretched, the system has reduced mobility constraints and increased independence for millions of women who rely on safe transport to access education and job opportunities; contributing to the city’s dynamism and growth. There are similarly inspiring examples from all countries in South Asia.

As we mark International Women’s Day, we celebrate the progress made in improving women’s inclusion and empowerment, while seeking to better address continuing challenges, which are estimated to cost South Asian economies $888 billion, through devising and implementing solutions that will bridge remaining gaps.

Much to be proud of­a lot more remains to be done

South Asian countries have seen encouraging increases in greater access and gender parity in education. At the same time, the region has achieved substantial decreases in maternal and child mortality. Countries have made great strides in healthcare access through training more female healthcare workers while providing affordable care for mothers and children. The region also boasts many inspiring female leaders and role models, as well as the countless individuals positively contributing to their communities and societies against difficult odds. 

However, much more needs to be done in order to nurture all women and men to realize their potential. As South Asian countries become more prosperous, their growth trajectory will be less assured if hundreds of millions of women remain excluded from education and employment opportunities. South Asian countries will need to substantially expand their workforce in order to meet their economic growth goals and, at the same time, adequately support their increasingly large populations. Studies show that only around 1 out of 4 women in South Asia participate in the labor force, about half of what is typical in middle-income countries in other regions. Too many women face restrictions in decision-making, mobility, public safety; and far too many experience gender-based violence—the most egregious cases making headlines around the world. What can help bridge these gaps?

Energy storage can open doors to clean energy solutions in emerging markets

Alzbeta Klein's picture

Also available in: French

Energy storage is a crucial tool for enabling the effective integration of renewable energy and unlocking the benefits of the local generation of clean resilient energy supply. Photo credits: IFC


For over a hundred years, electrical grids have been built with the assumption that electricity has to be generated, transmitted, distributed, and used in real time because energy storage was not economically feasible.
This is now beginning to change.


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